MEDICARE: BERNICE DEL ROSARIO DIONES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1487950473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERNICE DEL ROSARIO DIONES

Provider Business Mailing Address
First Line	:	604 BELMONT LN
Second Line	:
City	:	NORTH LAUDERDALE
State	:	FL
Zip	:	33068-4270
Country	:	US
Telephone Number	:	310-658-3242
Fax Number	:

Provider Business Practice Location Address
First Line	:	604 BELMONT LN
Second Line	:
City	:	NORTH LAUDERDALE
State	:	FL
Zip	:	33068-4270
Country	:	US
Telephone Number	:	310-658-3242
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2011
Last Update Date	:	02/08/2011

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